The greatest joy for a new mother is to breastfeed her child. But imagine, every time you try to breastfeed your baby, the baby cries, doesn't latch on properly, and doesn't suck. You also have cracked nipples and feel unbearable pain. Has this happened to you? Then one reason for this could be a small problem with the baby's tongue. In medicine, we call this Ankyloglossia , but we all know it by the name Tongue-Tie .
Simply put, what is Tongue-Tie?
We all have a small band of tissue under our tongue that connects it to the bottom of our mouth. If you look in a mirror and lift your tongue, you will see it. We call this band the lingual frenulum . It is present in all babies from birth. It usually does not cause any problems.
However, in some babies, this membrane can be a little thicker or shorter . When this happens, it becomes difficult for the baby to move the tongue freely back and forth and lift it up. That is what we call a Tongue-Tie. It is as if someone is holding the tongue under it. This can make it very difficult for the baby to suckle breast milk.
When breastfeeding, the baby has to use his tongue to grip the nipple and the dark area around it (areola) and suckle the milk in a rhythmic manner. However, a baby with Tongue-Tie cannot use his tongue properly, so this process cannot be done properly. This causes a lot of discomfort for both the baby and the breastfeeding mother.
But don't worry. This is a very common condition. If you are aware of this in advance and seek medical advice if necessary, it can be managed very easily.
How to recognize if you have Tongue-Tie? (Symptoms)
When this happens, both the baby and the breastfeeding mother may experience symptoms. Let's take a look at what these symptoms are. See if you have experienced one or more of these.
| Symptoms seen in the baby | Symptoms felt by a breastfeeding mother |
|---|---|
| Inability to latch on properly: The baby cries or pulls away from the breast when trying to feed. The baby cannot latch on deeply enough. | Cracked nipples and severe pain: Because the baby is not latching on properly, the nipples can become sore and cracked, causing unbearable pain every time you breastfeed. |
| A 'clicking' sound when sucking: Because the baby's mouth is not properly attached to the breast, a 'chaka chaka' sound may be heard when sucking. | Discomfort during breastfeeding: Breastfeeding is usually a comfortable experience. But if you have to breastfeed every time with pain, you need to be careful about it. |
| The baby is not gaining weight properly: Since the baby is not getting enough milk, the baby may not be gaining weight appropriately for his age. | Insufficient milk let-down and reduced milk supply: Because the baby is not sucking properly, the breast milk is not being properly emptied. If this continues, the brain will get the signal to 'reduce milk production' and your milk supply may also decrease. |
| Frequent demand for milk: Since the baby does not get enough milk at one time, he will start crying and asking for milk again after a while. |
But one thing to remember is that these symptoms are not specific to Tongue-Tie. These symptoms can also occur due to other problems during breastfeeding. Therefore, the best thing to do is to talk to your doctor about this. He or she can find out what the real cause is.
What does a baby's tongue look like?
If you look at a baby with a tongue-tie when they cry or open their mouth, the tip of their tongue may look like a heart-shaped piece . This is because the membrane under the tongue is very close to the tip of the tongue, pulling the middle part of the tongue downward. Sometimes this is not very obvious. Usually, doctors pay attention to this during the medical examination after the baby is born.
Why does this happen to some babies?
This is a congenital condition. This means that it occurs while the baby is still developing in the womb. Researchers have not yet found the exact cause of this. However, some studies suggest that there may be a genetic component to it. This means that if someone in the family has had tongue-tie before, there is a chance that the baby will also develop it. It has also been reported to be slightly more common in boys.
How does a doctor diagnose this condition?
When you tell your doctor about your baby's discomfort, he or she will follow several steps to determine if it is tongue-tie or another problem.
- They will ask you questions about things like how you feel while breastfeeding, your baby's behavior, how many times a day you breastfeed, how long you breastfeed, and whether you give your baby formula.
- The baby's medical history is reviewed: The doctor checks whether the baby has any other conditions, such as neurological disorders or heart disease, that could affect breastfeeding. This is because even if the tongue-tie is treated, if there is another problem, the difficulty in breastfeeding will not go away.
- Examining the baby: The doctor will carefully examine the inside of the baby's mouth, especially the tongue and the membrane under the tongue. He may also use his finger to check how tight or short it is, and how it affects the movement of the tongue.
- Breastfeeding observation: If you have a lactation consultant, she will watch you breastfeed your baby. She will observe things like your position and latch, and see if any changes can be made to help resolve the problem.
The important thing is that just because a baby's tongue appears to be a little tight or short, not every baby has tongue-tie, nor does it require treatment. Doctors only consider it a medical condition if the membrane is actually interfering with the baby's tongue function and causing problems with breastfeeding.
What are the treatments for tongue-tie?
There are two main treatments for this. Your doctor will assess your condition and that of your baby and recommend the most appropriate treatment.
1. Changing breastfeeding positions and techniques: This is often the first method to try. A lactation consultant can help you learn how to hold your baby in a way that makes it easier for him to latch on, and how to help him latch on properly. Many babies with tongue-tie can latch on well with these simple changes.
2. Frenotomy: Sometimes, if breastfeeding difficulties persist despite changing positions, doctors may recommend this minor procedure. This is not a major surgery. It is an in-office procedure that can be done in a minute or two in the doctor's office.
Does every baby need to have this surgery?
No, definitely not. Most babies do not need this surgery. As I said before, I only consider this if changing the breastfeeding position does not solve the problem.
In this procedure called frenotomy , special scissors or a laser beam are used to cut and release the tough membrane that is obstructing the movement of the baby's tongue. This is done very quickly. The baby does not feel much pain. Usually only one or two drops of blood are lost. The baby can be breastfed immediately after the surgery. When this is done, the baby forgets about the pain.
It is considered best to perform this surgery within the first month of the baby's life, as this makes it easier for the baby to establish the habit of breastfeeding properly from the beginning.
Can this surgery cause side effects?
This is a very safe procedure. Side effects are very rare. If they do occur, they may include:
- Slight bleeding
- Infection
- Scarring at the incision site
- Rarely, damage to the salivary glands (saliva ducts) in the mouth
Take-Home Message
- Tongue-Tie (Ankyloglossia) is a common condition seen in newborn babies. Don't be unnecessarily alarmed by it.
- This can cause difficulties for both the baby and the mother during breastfeeding. This includes pain, cracked nipples, and the baby's failure to gain weight.
- If you have any discomfort or pain while breastfeeding, don't just wait and hope, "It'll be okay in a few days," but see your doctor as soon as possible. This is not your fault.
- Not all cases of tongue-tie require surgery (frenotomy). In many cases, this problem can be resolved by changing breastfeeding positions and methods.
- Even if treatment is required, it is a very simple, quick, and safe process. So there is no reason to worry.
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